1. Cardiovascular Manifestations
Cardiovascular manifestations of pheochromocytoma include severe headaches and profuse sweating, palpita¬tions, severe labile hypertension or sustained severe hypertension, palpitations due to sinus tachycardia, and cardiac arrhythmias. A life-threatening myocarditis may occur, and in some cardiomyopathy and heart failure may develop that may be reversed when the offending tumor is removed.
Diagnosis requires the finding of an elevated 24-h urine total of metanephrines and an increase in plasma cate-cholamines. Elevated dopamine serum levels are estimated on the same blood samples taken for epinephrine, because dopamine may be the only chemical produced by some malignant pheochromocytomas. An MRI may reveal a tumor.
2. Management
Hypertensive crisis may require use of phentolamine before the administration of phenoxybenzamine. Nitro-prusside should be used to lower blood pressure during a crisis and nifedipine is also useful for emergency blood pressure control. Surgery provides an expected cure in up to 80% of patients.

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